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Organization
UNITED STATED NAVY
Active
Organization
UNITED STATED NAVY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUSTIN ROGER SMITH D.M.D. (DENTIST)
(770) 241-9192
Entity
Organization
Contact information
Practice address
BLDG H 2005 KNIGHT LANE, NAVY MEDICINE SUPPORT SUPPORT COMMAND ATTN: MEDICAL STA, JACKSONVILLE, FL 32212-0140
(760) 725-3213
Mailing address
BLDG H 2005 KNIGHT LANE, NAVY MEDICINE SUPPORT SUPPORT COMMAND ATTN: MEDICAL STA, JACKSONVILLE, FL 32212-0140
(760) 725-3213
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8727
SC
Other
Enumeration date
07/12/2016
Last updated
07/12/2016
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